Acute Kidney Injury and Its Short-Term Outcomes among Children with Malaria Admitted to the National Institute of Child Health: Acute Kidney Injury and Outcomes among Children with Malaria

Abdul Qadeer Shaikh; Bilquis Naeem; Hina Fatima; Lubna Aman; Wajid Hussain

doi:10.54393/pjhs.v7i1.3529

Authors

Abdul Qadeer Shaikh Department of Pediatric Medicine, National Institute of Child Health, Karachi, Pakistan
Bilquis Naeem Department of Pediatric Nephrology, National Institute of Child Health, Karachi, Pakistan
Hina Fatima Department of Pediatric Nephrology, National Institute of Child Health, Karachi, Pakistan
Lubna Aman Department of Pediatric Nephrology, National Institute of Child Health, Karachi, Pakistan
Wajid Hussain Department of Pediatric Medicine, National Institute of Child Health, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i1.3529

Keywords:

Acute Kidney Injury, Dehydration, Hypotension, Dialysis, Malaria, Mortality

Abstract

In Pakistan, the overall reported contribution of malaria to acute kidney injury (AKI) is not well studied. Objectives: To determine the frequency and short-term outcomes of AKI in children presenting with malaria. Methods: This analytical, cross-sectional study was conducted at the National Institute of Child Health, Karachi, Pakistan, during 13^th January 2025 to 13^th July 2025. Children aged 1-16 years with confirmed malaria were analyzed. Detailed demographic, clinical, and laboratory data were collected. AKI was staged using KDIGO criteria. Outcomes included need for dialysis, hospital stay, and mortality. Data were analyzed using IBM-SPSS Statistics, version 26.0. Statistical significance was set at p<0.05. Results: Among 237 children, 135(57.0%) were male, while the mean age was 7.9 ± 3.6 years. AKI was identified in 28 (11.8%; 95% CI: 7.9-16.5%) children. Fever was universally present in all children. Oliguria was significantly more frequent in children with AKI (64.3% vs. 7.2%, p<0.001). Oliguria (64.3% vs. 7.2%, p<0.001), dehydration (57.1% vs. 22.0%, p<0.001), and hypotension (25.0% vs. 4.3%, p<0.001) were significantly more common among children with AKI. Dialysis or renal replacement therapy was required in 21.4% children with AKI (p<0.001). Mortality occurred 10.7% children with AKI vs. 0% without AKI (p<0.001). Conclusions: AKI affects a notable proportion of children hospitalized with malaria. AKI in malaria is linked to more severe clinical presentation and significantly worse short-term outcomes.

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